Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12268-12277
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12268
Case mistaken for leukemia after mRNA COVID-19 vaccine administration: A case report
Seul Bi Lee, Chi Young Park, Sang-Gon Park, Hee Jeong Lee
Seul Bi Lee, Chi Young Park, Sang-Gon Park, Hee Jeong Lee, Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, Gwangju 501-717, South Korea
Author contributions: Lee SB contributed mainly to the writing of the manuscript; Park SG and Park CY advised on manuscript drafting; Lee HJ proofread and revised the manuscript as a corresponding author; all authors have approved this version for publication.
Supported by Chosun University, 2020.
Informed consent statement: A written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hee Jeong Lee, PhD, Professor, Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, South Korea. hjangel21c@hanmail.net
Received: June 9, 2022
Peer-review started: June 9, 2022
First decision: July 29, 2022
Revised: September 6, 2022
Accepted: October 20, 2022
Article in press: October 20, 2022
Published online: November 26, 2022
Processing time: 167 Days and 4.7 Hours
Abstract
BACKGROUND

Following the global outbreak of coronavirus disease 2019 (COVID-19), unlike other vaccines, COVID-19 vaccines were developed and commercialized in a relatively short period of time. The large-scale administration of this vaccine in a short time-period led to various unexpected side effects, including severe cytopenia and thrombosis with thrombocytopenia syndrome. Despite many reports on adverse reactions, vaccination was necessary to prevent the spread of COVID-19; thus, it is essential to understand and discuss various cases of adverse reactions after vaccination.

CASE SUMMARY

A 77-year-old woman was administered the second dose of Pfizer mRNA COVID-19 vaccine. After vaccination she experienced fever, myalgia, and weakness. Antibiotics were subsequently administered for several days, but there was no improvement in the symptoms. The patient showed severe thrombocytopenia and leukocytosis. Thoracic and abdominopelvic computed tomography showed no infection related findings, but splenomegaly and cirrhotic liver features were observed. A large number of immature cells were observed in the peripheral blood smear; thus, bone marrow examination was performed for acute leukemia. However, there were no abnormalities. The patient recovered after administration of hepatotoxins and transfusion treatment for cytopenia and was diagnosed with an adverse reaction to COVID-19 vaccination.

CONCLUSION

Adverse reactions of vaccination could be mistaken for hematologic malignancies including leukemia. We report a patient with leukocytosis following COVID-19 vaccination.

Keywords: COVID-19; Vaccine; mRNA; Leukocytosis; Adverse reaction; Case report

Core Tip: Cases of cytopenia or thrombosis with thrombocytopenia syndrome after coronavirus disease vaccination have been reported. We report a case of suspected hematologic malignancy, i.e., leukemia after vaccination in a female patient. Adverse reactions of vaccination could be mistaken for hematologic malignancies.